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NPI Code Detail

MEDICARE: ARIZONA SURGICAL PHYSICIAN ASSISTANTS LLC

MEDICARE: ARIZONA SURGICAL PHYSICIAN ASSISTANTS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician Assistant2722AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477790343
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARIZONA SURGICAL PHYSICIAN ASSISTANTS LLC
Provider Business Mailing Address
First Line : 7616 W NAVIGATOR LN
Second Line :
City : PEORIA
State : AZ
Zip : 85383-2246
Country : US
Telephone Number : 602-790-5410
Fax Number :
Provider Business Practice Location Address
First Line : 19829 N 27TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85027-4001
Country : US
Telephone Number : 623-879-6100
Fax Number :
Authorized Official
Title or Position : OWNER - PA
Name : KARLA N FRICK
Credential : PA-C
Telephone Number : 602-790-5410
Provider Enumeration Date : 01/14/2009
Last Update Date : 11/04/2025

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